Cerner President Disputes Characterization of DoD Implementation Problems

A 1998 photograph of the Pentagon. Photo is in the public domain.

Less than 24 hours after Cerner officially announced its long-awaited contract with the Department of Veterans’ Affairs (VA), the President of the electronic medical records (EMR) giant insinuated that reports of implementation problems at the Department of Defense (DoD) were “fake news,” and perhaps born out of competitive envy.

Both agencies are working to adopt Cerner’s MHS Genesis platform, a customized version of its flagship Millennium system. A driving force behind the decision to replace the VA’s legacy EMR with Cerner’s product was the prospect of interoperability with DoD, which had a pre-existing deal with the company.

>>READ: The Chasm Between Public Perception and Clinical Reality at the VA

That implementation began more than a year ago at 4 DoD health facilities in the Pacific Northwest, but some early and aggressive reporting by Politico characterized the rollout as hectic and worrisome. On the day that Cerner announced that the VA contract had been finalized, the publication’s headline read “VA joins military in fraught multibillion-dollar health IT contract.”

But in Friday’s meeting with shareholders, Cerner President Zane Burke cast the situation in a much different light.

“I have learned the term ‘fake news’ a little bit, so if you followed a little bit of the one side of this, there’s been some concern about some of the delivery on the DoD side. I’ll tell you that’s gone incredibly well overall,” he said. About a week before the first major exposé on the situation was published, his company released a top-line report highlighting positive early outcomes of the transition, like reduced hospital stay times for patients with sepsis and a reduction in duplicative procedures.

But the conflicting stories have since been joined by an internal DoD report, made public at the beginning of this month, in which the agency’s Director of Operational Test and Evaluation, Robert F. Behler, wrote that “MHS Genesis is not operationally suitable because of poor system usability, insufficient training, and inadequate help desk support.” Users were successful in performing “only” 56% of nearly 200 tasks considered to be indicators of the system’s performance, and Behler recommended that the Under Secretary of Defense for Acquisition and Sustainment “delay further fielding” until deficiencies were resolved.

Cerner’s president, though, said that “there were some known elements” as the company transitioned the first 3 sites to its custom platform, and that the “plan always was to come back and do a remediation of those 3 sites, do an evaluation, and make things better.”

Further, he suggested that reports of issues with the rollout may have even been competitively motivated by the EMR vendor’s rivals: “If you had an axe to grind with us and might have wanted perhaps to keep us from getting a [VA] contract, and you’re one of our competitors, you might have wanted to use some information negatively,” Burke said.

The Politico reports quoted anonymous clinicians from the health centers where MHS Genesis was first deployed. Contacts worried that the implementation had been extremely stressful and posed a potential threat to patient safety.

Those reports were not the only criticism that a government-backed Cerner implementation has received recently. Right across the border from some of the Washington state DoD facilities, a report emerged from the Vancouver Island Health Authority in British Columbia, Canada, detailing that health system’s transition. Cost overruns totaled in the tens of millions, and more than half of over 600 staff surveyed reported that the process decreased the likelihood of safe patient outcomes, with more than a quarter saying it did so “significantly.”

“While Cerner Millennium can be complex to use, it is accepted within the industry that it is one of the two leading advanced EHR system,” that report states, however. “An EHR is a tool, and other organizations have seen more broadly measureable benefits using Cerner Millennium after a stabilization period.”

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